Abstract
Experience-based co-design in healthcare is based on three pillars: performance + engineering, + experience. We can determine an effective and sustainable approach to change and transformation without understanding the nuances of the lived experiences of those for whom the system exists. At 4C Strategy, we believe that we can co-design a solution until we co-define the problem. When a system or provider lens provides the only understanding of a situation, we are missing an important lens. Even if we are in the same environment, the experiences are distinctly different for each person depending on their role. Take this simple example - a healthcare reception area where the healthcare professional is sitting behind the glass, and the patient or caregiver has to crouch down to see eye-to-eye with the provider. The environment is the same, but the experience is distinctly different between the two. If we solve for the experience of the professional, at best, we don't improve the experience for the patient and caregiver; at worst, we make their experience worse. That where meaningful engagement and co-design come into play. Unfortunately, engagement and co-design are buzzwords that have almost lost their power and meaning. But when we go back to the fundamentals of experience-based co-design, we can drive change. 4C Strategy has been honing this approach over the past 0 years, and has developed Impact Narratives - a tailored and curated approach strategically aligned with the challenge at hand. One recent example illustrates the power of recognizing, supporting and validating lived experience as an important input into systems change. Christa and Terrence will share their experience in developing an Impact Narrative as a key component of engagement and co-design activities, and how it differs from the standard approach to storytelling. The role of Impact Narratives in understanding the lived experience of caregivers and patients is profound, as illustrated by Terrence's keynote speech at the OCO Roundtable. Here is one example of how his Impact Narrative illustrated a commonly cited fact in a way that had never been seen before. In his keynote speech at the OCO Roundtable event in February 2024, Terrence Ho shone a spotlight on the fact that 75% of care is provided by family caregivers. He stated the fact and showed a weekly calendar for the care schedule for his brother, highlighting all the hours when the family held primary caring responsibility. It was a profound moment that made this fact, that is often cited, finally hit home for many providers in the room. With this understanding, how can we lead change in the healthcare system, or commit to integrated care, without the equal and valued inclusion of caregivers? This came out even more loud and clear through the comments from caregivers and providers at the event: not that the caregivers should be included -it is that they are the care team/ They are the first responders, and the providers are the supplementary support team. Families dont see the silos and are key ingredients to identify and break down the silos. They question the silos and ask the important questions. The caregiver is the broker for collaboration. They can break through historical or institutional conflict. Conflict is kryptonite to collaborative care. Caregivers and their experiences simply must be central to transforming healthcare. Impact Narratives are an emerging and powerful way to make this happen. Terrence and Christa will deliver a workshop that helps others create their own approach to developing Impact Narratives.